Arrangement for and method of monitoring, calibrating and optimizing a control of an electromedical implant

Abstract

An arrangement (10) for monitoring and adjusting a control of an electromedical implant (12) by means of an external control and evaluation unit (14) is made up of the electromedical implant, the external control and evaluation unit and a central, autarchically runnable evaluation logic means (30) which controls the activities of a telemetry unit (16) and a memory unit (34), which is connected to a clock and timer unit (42) and which on the basis of certain communicated data ascertains control sequences and control parameters for monitoring and adjusting the implant and co-ordinates the transmission thereof to the implant. An expert system (ES) may be adapted to assess all monitoring and adjusting tasks on a patient-individual basis.

Description

[0001]The invention concerns an arrangement for monitoring and adjusting a control of an electromedical implant for intracardial cardiac therapy by means of an external control and evaluation unit, an associated method and the external control and evaluation unit itself having the features set forth herein.BACKGROUND OF THE ART[0002]Electromedical implants such as cardiac pacemakers and defibrillators have proven to be an extraordinarily successful instrument for the electrotherapy of bradycardiac and tachycardiac rhythm disturbances. In that respect the task of implants of that kind is not restricted just to merely delivering electrical pulses to the atrium or ventricle myocardium in order there to trigger off depolarization. Rather, modern pacemakers and defibrillators involve sensors and evaluation circuits which permit controlled or regulated frequency adaptation, adaptation of pulse amplitude, pulse width and AV-time for therapy optimization purposes. In that way the aim is for...

AI Technical Summary

Benefits of technology

[0007]Therefore the object of the present invention is to provide an arrangement for and a method of monitoring and adjusting the control of the electromedical implant for intracardial cardiac therapy with which the mobility of the patient is substantially improved. Along with that the invention seeks to improve in particular optimization of the control parameters on the basis of intracardial signals recorded under everyday conditions. The system is to operate as independently as possible and is to be capable of reacting flexibly to the possibly altered conditions without the patient having to submit to time-consuming clinical investigations.

[0023]The autarchically runnable control logic unit of the implant firstly ensures comfortable everyday operation so that the implant and the external control and evaluation unit do not have to be permanently in telemetric contact. The control and evaluation unit with its autarchically runnable evaluation logic unit contains sequences which permit very much more extensive evaluation and optimization of the control.

[0038]It is further preferable if the evaluation logic unit of the external control and evaluation unit has a memory for a complex matrix into which at least the communicated data of the implant and further control parameters pass. By means of such a matrix it is possible speedily to ascertain the control parameters and control sequences on which the monitoring and adjusting tasks are based.

Problems solved by technology

More extensive tasks such as for example monitoring and optimizing the control itself can generally only be implemented to a very limited degree.

That is not only due to the fact that the implementation of such complex control circuits in the limited structural space of the implant encounters at the present time the viable limits thereof.

Rather, such a complex control circuit would also result in a markedly increased level of energy consumption so that the service life of the implant would be curtailed.

Also, in general a defective control logic system cannot check and re-set itself.

A disadvantage here is that the external electrical stimulator is an essential part of the control of the implant and, in the event of failure thereof, the implant can continue to operate at best in a predetermined basic configuration.

Accordingly the patient has to stay in the clinic in the procedure involving programming, optimization and implementation of an exercise stress test, in which respect he is additionally impeded by extensive cabling.

As is known, the unusual surroundings result in what is referred to as the white coat effect in which the cardiovascular system of the patient is precisely not subject to everyday conditions and thus optimization of the stimulation effect is made difficult or entirely prevented.

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